One of the most difficult decisions an individual or their children will face is when an elderly person should stop driving. Putting the car keys away can feel like a loss of independence, especially if aging has brought on other limitations in a person’s life.

The decision to stop driving can be difficult for seniors, and often the responsibility can fall to their children to spot warning signs. While taking this step can be life-changing, it can also save lives. Thousands of seniors are killed or injured in car crashes every year. Part of the reason for the high number of deaths and injuries can be attributed to increased frailty with age. However, keeping elderly drivers out of dangerous situations on the road can keep them from being hurt or killed in a crash. Here are four signs that a person should stop driving.

Deteriorating or Impaired Health

Some health conditions can make it difficult to drive safely. Parkinson’s disease can affect a person’s physical ability to drive a car well, while dementia can impair a person’s judgment behind the wheel. Other health conditions may require medications that would make it unsafe to drive. It is important to talk to your doctor about whether your health or medications stand in the way of your driving. “Medications can cause impairment for drivers, even if they cannot feel a difference,” said Etelka Bailey, executive director of Lake Ridge Assisted Living Center. “Be sure to discuss any side effects with your doctor or pharmacist before getting behind the wheel.”

Sensory Impairment

Eyesight or hearing problems can make it unsafe to drive a car. Get regular eye and hearing checks to make sure you are still able to drive safely. A doctor may recommend that a person stop driving temporarily or permanently due to impaired eyesight or trouble hearing. Some conditions—like cataracts or macular degeneration—can make it difficult to see well at night, and hearing impairment can affect whether a person can react to dangers on the road.

Worsened Driving Ability

A person’s driving skills may decrease with age, making them hazardous behind the wheel of a car. Some signs that a person has become an unsafe driver include close calls while driving, driving at inappropriate speeds, weaving in and out of lanes, or hitting curbs. If these things begin to happen, it might be time to hang up the car keys.

Confusion

An important aspect of competent driving is the ability to maintain composure in the car. Getting confused while driving can put a person at an increased risk of getting lost or causing an accident. If a person begins to have a hard time following driving directions or gets confused when driving in unfamiliar places, it could be a good idea to find other means of transportation.

A lot can change for a person as they get older. While physical and mental changes do not always signal the end of driving a car, it is important to recognize when it is no longer safe to be behind the wheel. Watch for these critical signs to determine whether it’s time to find other transportation. Even if it isn’t time to stop driving, be sure to get regular checkups to determine whether any health conditions could cause impairment and get appropriate treatment.